HomeMy WebLinkAboutNCGNE0162_COMPLETE FILE - HISTORICAL_20091105STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
NCGNE O I
DOC TYPE
Vf HISTORICAL FILE
DOC DATE
❑ �L
YYYYMMDD
AM
'
NCDENR
pmmru!vi vrtr Nauw. w.w.,�:r.o
Division of Water Quality ) Surface Water Protection
National Pollutant Discharge Elimination System
NO EXPOSURE CERTIFICATION for Exclusion
NCGNE0000
FOR AGENCY USE ONLY
Dme Rw6i.d
Yurr Month
My
I
I
Ccnific.w of Cnvcleb'c
E
MCC �1), 0161
NO EXPOSURE CERTIFICATION Please check here it this is a renewal: ❑ RENEWAL
National Pollutant Discharge Elimination System application for exclusion from a Stormwaler Permit based
on NO EXPOSURE:
Submission of this No Exposure Certification constitutes notification that your facility does not require a
permit for stormwater discharges associated with industrial activity in the State of North Carolina because
it qualifies for a no exposure exclusion. A condition of no exposure at an industrial facility means all
industrial materials and activities are protected by a storm resistant shelter (with some exceptions) to
prevent exposure to rain, snow, snowmelt, and/or runoff.
For permitted facilities in North Carolina, DWQ must approve your application for No
Exposure Certification before this exclusion is effective. Until you are issued a No
Exposure Certification and your NPDES permit is rescinded, your facility must continue
to abide by the terms and conditions of the current permit.
Industrial materials or activities include, but are not limited to: material handling equipment or activities,
industrial machinery, raw materials, intermediate products, by-products, final products, or waste products.
Material handling activities include the storage, loading and unloading, transportation, or conveyance of
any raw material, intermediate product, final product or waste product. A storm resistant shelter is not
required for the following industrial materials and activities: drums, barrels, tanks, and similar containers
that are tightly sealed, provided those containers are not deteriorated and do not leak. "Sealed" means
banded or otherwise secured and with locked or non -operational taps or valves; adequately maintained
vehicles used in material handling; and final products, other than products that would be mobilized in
stormwater discharges (e.g., rock salt).
A No Exposure Certification must be provided for each facility qualifying for the no exposure exclusion. In
addition, the exclusion from NPDES permitting is available on a facility -wide basis only —not for individual
outtalls. If any industrial activities or materials are, or will be, exposed to precipitation, the facility is not
eligible for the no exposure exclusion. By signing and submitting this No Exposure Certification form, you
certify that a condition of no exposure exists at this facility or site and are obligated to comply with the
terms and conditions of 40 CFR 122.26(g).
You are required to reapply for the No Exposure Exclusion once every five (5) years.
For questions, please contact the DWO Regional Office for your area. (See page 6)
(Please print or type)
1) Mailing address of owner/operator (address to which all certification correspondence will be mailed):
Name
Contact
Street Address
City
Telephone No.
S W U-NE-021309
I
Page 1 of 7
.I I
l'
"'' _ C 2009 Last revised 2/13/2009
NCGNE0000 No Exposure Certification
2) Location of facility producing discharge:
Facility Name
Facility Contact
Street Address
City
County
Telephone No.
3) Physical location information:
Please provide a narrative description of how to get to th facility (us stre t names, state road numbers, and
distance and direction from a roadway intersection). � ee �Q Ch Yv� 'C V1� S
(A copy of a map with the facility clearly located on it should be included with the certification application.)
4) Is the facility located on Native American Lands? ❑ Yes )(No
5) Is this a Federal facility? ❑ Yes ANo
6) Latitude 35 OLf 9 15+P/ Longitude 14�0IS I I Q1r/ IAI (deg., min., seconds)
7) This NPDES No Exposure Exclusion application applies to which of the following:
❑ New or Proposed Facility Date operation is to begin
❑ Existing Date operation began
K Renewal of existing No Exposure Certification Certification No.: NCGNE 0
6) Was this facility or site ever covered under an NPDES Stormwater Permit? XYes ❑ No
If yes, what is the NPDES Permit Number? n/GGo50 158
9) Standard Industrial Classification:
Provide the 4 digit Standard Industrial Classification Code (SIC Code) that describes the primary industrial
activity at this facility
SIC Code: 3— 0
10) Provide brief description of the types of industrial activities and products produced at this facility:
11) Does this facility have any Non -Discharge permits (ex: recycle permits)?
)(No
❑ Yes
If yes, list the permit numbers for all current Non -Discharge permits for this facility:
Page 2 of 7
SWU-NE-021309 Last revised 2/13/2009
NCGNE0000 No Exposure Certification
Exposure Checklists (12. - 14.)
12) Are any of the following materials or activities exposed to precipitation, now or in the foreseeable
future? (Please check either "Yes" or "No.") If you answer "Yes" to any of these items, you are not
eligible for the no exposure exclusion.
a. Using, storing, or cleaning industrial machinery or equipment, and areas where ❑ Yes X No ❑ N/A
residuals from using, storing or cleaning industrial machinery or equipment remain
and are exposed to stormwater
b. Materials or residuals on the ground or in stormwater inlets from spills/leaks ❑ Yes XNo ❑ N/A
c. Materials or products from past industrial activity
❑ Yes
K No
❑ N/A
d. Material handling equipment (except adequately maintained vehicles)
❑ Yes
X No
❑ N/A
e. Materials or products during loading/unloading or transporting activities
❑ Yes
X No
❑ N/A
I. Materials or products stored outdoors (except final products intended for outside
❑ Yes
K No
❑ N/A
use [e.g., new cars] where exposure to stormwater does not result in the discharge
of pollutants)
g. Materials contained in open, deteriorated or leaking storage drums, barrels, tanks,
❑ Yes
[A No
❑ N/A
and similar containers
h. Materials or products handled/stored on roads or railways owned or maintained by
❑ Yes
X No
❑ N/A
the discharger
i. Waste material (except waste in covered, non -leaking containers [e.g., dumpsters])
❑ Yes
XNo
❑ N/A
j. Application or disposal of process wastewater (unless otherwise permitted)
❑ Yes
A No
❑ N/A
k. Particulate matter or visible deposits of residuals from roof stacks and/or vents not ❑ Yes PI No ❑ N/A
otherwise regulated (i.e., under an air quality control permit) and evident in the
stormwater outflow
I. Empty containers that previously contained materials that are not properly stored ❑ Yes F( No ❑ N/A
(i.e., not closed and stored upside down to prevent precipitation accumulation)
m. For any exterior ASTs, as well as drums, barrels, tanks, and similar containers ❑ Yes 4 No ❑ N/A
stored outside, has the facility had any releases in the past three (3) years?
13) Above Ground Storage Tanks (ASTs): If you answer "No" to any of the following items, you are not
eligible for the no exposure exclusion.
a. Are exterior ASTs or piping free of rust, damaged or weathered coating, pits, or Yes ❑ No ❑ N/A
deterioration, or evidence of leaks?
b. Is secondary containment provided for all exterior ASTs? If so, is it free of any Yes ❑ No ❑ N/A
cracks, holes, or evidence of leaks, and are drain valves maintained locked shut?
Page 3 of 7
SWU-NE-021309 Last revised 2/13/2009
NCGNE0000 No Exposure Certification
14) Secondary Containment: If you answer "No" to any of the following items, you are not eligible for the
no exposure exclusion.
a. Is secondary containment provided for single above ground storage containers ❑ Yes ❑ No XN/A
(including drums, barrels, etc.) with a capacity of more than 660-gallons?
b. Is secondary containment provided for above ground storage containers stored ❑ Yes ❑ No N/A
in close proximity to each other with a combined capacity of more than 1,320-
gallons?
c. Is secondary containment provided for Title III Section 313 Superfund
Amendments and Reauthorization Act (SARA) water priority chemicals'?
d. Is secondary containment provided for hazardous substances" designated in 40
CFR §116?
e. Are release valves on all secondary containment structures locked?
15) Hazardous Waste:
a. Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility?
b. Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste
generated per month) of hazardous waste?
c. Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste
generated per month) of hazardous waste?
If you answered yes to questions b. or c., please provide the following information:
Type(s) of waste: _ U
How is material stored: _
Where is material stored:
How many disposal shipments per year:
Name of transport / disposal vendor: _
Vendor address: 3 9 3 0 (`-, leln t
Footnotes to Questions 14) c. & d.
❑ Yes ❑ No X N/A
❑ Yes ❑ No KN/A
❑ Yes ❑ No KN/A
❑ Yes A No ❑ N/A
'Yes ❑ No ❑ N/A
❑ Yes XNo ❑ N/A
'Note that amounts below the 660-gallon (single) and 1,320-gallon (combined) bulk storage minimums require
secondary containment. However, some exceptions may be made for de minimis amounts of certain substances,
and/or other qualifiers, as described in the exemptions from reporting requirements of Title III SARA 313 in 40 CFR
§372.38.
"Note that amounts below the 660-gallon (single) and 1,320-gallon (combined) bulk storage minimums require
secondary containment. However, some exceptions may be made for amounts less than the Reportable Quantities
of the hazardous substances listed in 40 CFR §117.3.
Page 4 of 7
SWU-NE-021309 Last revised 2/13/2009
C•
_
r
t
9
NCGNE0000 No Exposure Certification
16) Other information: If you answer "Yes" to any of the following items, you might not be eligible for the
no exposure exclusion. A more in-depth evaluation of the site circumstances may be required.
a. Does your facility store used, recycled, or otherwise reclaimed pallets outside? ❑ Yes No ❑ N/A
b. Does your facility have coal piles on site? ❑ Yes No ❑ N/A
c. Does your facility store other fuel sources outside in piles, such as wood chips, ❑ Yes J$( No ❑ N/A
sawdust, etc.?
d. Does your facility have air emissions associated with its industrial activity (e.g., KYes ❑ No ❑ N/A
degreasing operatio plating, painting and metal finishing)? If so, describe the l
industrial activity: pair 2X�tJS�or% wiJ VOC Cry
e. If you answered yes to d., are those emissions permitted an Air Quality Permit? Yes ❑ No ❑ N/A
Please specify: 'r+12 V A:,r Pat nn7+ KJ 0V+3Li-nj
f. Please list any other environmental program permits (federal, state, etc.) not
specified earlier in this application (such as Hazardous Waste Permits, etc.):
Permit: NOR00013�3552 , Program: OaT iNQ5+e.
Permit:
Program:
Permit:
Program:
Permit:
Program:
Permit:
Program:
Permit:
Program:
Permit:
Program:
Page 5 of 7
SW U-NE-021309 Last revised 2/13/2009
NCGNE0000 No Exposure Certification
17) Certification:
I certify under penalty of law that I have read and understand the eligibility requirements for claiming a condition of "no
exposure' and obtaining an exclusion from NPDES stormwater permitting.
I certify under penalty of law that there are no discharges of stormwater contaminated by exposure to industrial activities
or materials from the industrial facility or site identified in this document (except as allowed under 40 CFR 122.26(g)(2)).
I understand that I am obligated to submit a no exposure certification form once every five (5) years to the North Carolina
Division of Water Quality and, if requested, to the operator of the local municipal separate storm sewer system (MS4) into
which the facility discharges (where applicable). I understand that I must allow the North Carolina Division of Water
Quality, or MS4 operator where the discharge is into the local MS4, to perform inspections to confirm the condition of no
exposure and to make such inspection reports publicly available upon request.
In the event that the site no longer qualifies for a No Exposure Exclusion, I understand that I must obtain coverage under
an NPDES permit prior to any point source discharge of stormwater from the facility. Additionally, I certify under penalty of
law that this document and all attachments were prepared under my direction or supervision in accordance with a system
designed to assure that qualified personnel properly gathered and evaluated the information submitted. Based on my
inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the
information, the information submitted is to the best of my knowledge and belief true, accurate and complete. I am aware
that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for
knowing violations.
I certify that I am familiar with the information contained in this application and that to the best of my knowledge and belief
such information is true, complete, and accurate.
Printed Name of Person Signing: t'f`41CV f M $ S ro h
Title: . May`a9er ,�,�nJ�re.�r�le.v eC,--%CA'1
�eLh I -L 107
(Signature of Applic t) (Date Signed)
Please note: This application for the No Exposure Exclusion is subject to approval by the
NCDENR Regional Office prior to issuance. The Regional Office may inspect your facility for
compliance with no exposure conditions prior to that approval. The Regional Office may also
inspect your facility at any time in the future for compliance with the No Exposure Exclusion.
North Carolina General Statute 143-215.6 B(i) provides that:
Any person who knowingly makes any false statement, representation, or certification in any application, record, report, plan, or other
document filed or required to be maintained under this Article or a rule implementing this Article; or who knowingly makes a false
statement of a material fact in a rulemaking proceeding or contested case under this Article; or who falsities, tampers with, or knowingly
renders inaccurate any recording or monitoring device or method required to be operated or maintained under this Article or rules of the
[Environmental Management] Commission implementing this Article shall be guilty of a Class 2 misdemeanor which may include a fine
not to exceed ten thousand dollars ($10,000).
There is currently no fee for a No Exposure Exclusion.
Page 6 of 7
SWU-NE-021309 Last revised 2/13/2009
NCGNE0000 No Exposure Certification
Final Checklist
This application should include the following items:
a' This completed application and all supporting documentation.
A map with the location of the facility clearly marked.
If this is a renewal, indicated current NCGNE number in Question 7.
fd If the site currently has an NPDES Stormwater Permit, be sure to indicate the permit number in Question 8.
Mail the entire package to:
Stormwater Permitting Unit
Division of Water Quality
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Note
The submission of this document does not guarantee the issuance of a No Exposure Exclusion.
For questions, please contact the DWO Regional Office for your area.
DWQ Regional Office Contact Information:
Asheville Office ......
(828) 296-4500
Fayetteville Office ...
(910) 433-3300
Mooresville Office ...
(704) 663-1699
Raleigh Office ........
(919) 791-4200
Washington Office ...(252)
946-6481
Wilmington Office ...
(910) 796-7215
Winston-Salem ......
(336) 771-5000
Central Office .........(919)
807-6300
Page 7 of 7
SWU-NE-021309 Last revised 2/13/2009
Google Maps Page 1 of 1
Google maps GetGoogleMaps onyour phone
Twthemrd "GMAPS"to466453
i
�P
Bu_ q� _Rd
I L.J State Re i
U� ad 23ZQ
r
O!d —nn Rd
4 B
JO
tA\
Nomaco
East Wake N 1p C
Nomacac
Zet)dnn NµGTK
tAiddle
02009
A. Nomaco Inc
501 NMC Dr, Zebulon, NC - (919) 655-0801
http://maps.google.com/maps?hl=en&source=hp&ie=UTF8&q=nomaco&fb=1 &gl=us&hq... 1 l /2/2009
Driving directions to Nomaco Inc
25.8 mi — about 28 mins from downtown Raleigh
4 Raleigh, NC
1. Head east on E South St toward S Wilmington St
2. Turn right at the 1st cross street onto S Blount St
3. Continue onto Hammond Rd
4. Merge onto 140 EWS-64 E via the ramp to 1-440
5. Continue onto 1440 W
6. Slight right at US-64 E (signs for US-64 EIUS-264 EfWllson/Rocky Mt)
7. Continue onto US-264 E (signs for US-264 EfWilson/State Route
97/Greenville)
8. Take the exit toward N Carolina 97 WE Gannon Ave
9. Turn right at N Carolina 97 W/E Gannon Ave
10. Take the 1st right onto Industrial Dr
11. Turn right at N M C Dr
ci) 0.1 mi
no 0.6 mi
r, 0.7 mi
o) 2.4 mi
2.6 mi
s 17.3 mi
C,s, 0.7 mi
sj 0.2 mi
rat 0.7 mi
s 0.3 mi
rF Michael F. Easley, Governor
90 William G. Ross Jr., Secretary
�G North Carolina Department of Environment and Natural Resources
r
Alan W. Klimek, P. li. Director
-.( Division or Water Quality
'< Coleco 11. Sullins, Deputy Director
Division of Water Quality
April 20, 2005
Mark Caputo
Nomaco Inc
501 Nmc Dr
Zebulon, NC 27597
Subject: No Exposure Certification NCGNE0162
Nomaco Incorporated - 501 Nmc Dr
Wake County
Dear Permittee:
The Division has reviewed your submittal of the No -Exposure Certification for Exclusion from NPDES
Stormwater Permitting form, which we received on September 8, 2003. We apologize for the extended period
it has taken us to get back to you on this request and we appreciate your patience as we have worked through
this process. Based on your submittal and signed certification of no exposure at the above referenced facility
the Division is granting your certification as provided for under 40 CFR 126.22(g) which is incorporated by
reference in North Carolina regulations. In addition, your coverage under general permit NCG050158 is also
hereby rescinded. This rescission is based upon your certification of no exposure conditions at this facility.
Please note that by our acceptance of your no exposure certification, you are obligated to maintain no
exposure conditions at your facility. If conditions change such that your facility can no longer qualify for a no -
exposure exclusion, you are obligated to immediately obtain NPDES permit coverage for your stormwater
discharge. Otherwise, the discharge becomes subject to enforcement as an un-permitted discharge. Your
conditional no -exposure exclusion expires in five years (April 30, 2010). At that time you must re -certify with
the Division, or obtain NPDES permit coverage for any stormwater discharges from your facility.
Your certification of no exposure does not affect your facility's legal requirements to obtain environmental
permits that may be required under other federal, state, or local regulations or ordinances.
If you have any questions or need further information, please contact Jonathan Diggs at (919) 733-5083 ext.
537, or at jonathan.diggs@ncmail.net.
Sincerely,
for Alan W. Klimek, P.E.
cc: Raleigh Regional Office Central Files —w/attachments
Stormwater Permitting Unit Files Fran McPherson - DWQ Budget
N. C. Division of Water Quality 1617 Mail Service Center Raleigh, North Carolina 27699-1617 (919) 733-701 i
_�
TKW
NCDENR
Customer Service
1-877-623-6748
I
United States Environmental Protection A en Form Approved
NPDES A Washington, DC 20460 g y OMB No. 2040.0211
FORM ®"'fir/
3610-11 EPA NO EXPOSURE CERTIFICATION for Exclusion from
NPDES Storm Water Permitting
Submission of this No Exposure Certification constitutes notice that the entity identified in Section A does not require permit authorization for its storm water
discharges associated with industrial activity in the State identified in Section B under EPA's Storm Water Multi -Sector General Permit due to the existence
of a condition of no exposure.
A condition of no exposure exists at an industrial facility when all industrial materials and activities are protected by a storm resistant shelter to prevent
exposure to rain, snow, snowmelt, and/or runoff. Industrial materials or activities include, but are not limited to, material handling equipment or activities,
industrial machinery, raw materials, intermediate products, by-products, final products, or waste products. Material handling activities include the storage,
loading and unloading, transportation, or conveyance of any raw material, intermediate product, final product or waste product. A storm resistant shelter is
not required for the following industrial materials and activities:
- drums, barrels, tanks, and similar containers that are tightly sealed, provided those containers are not deteriorated and do not leak. "Sealed"
means banded or otherwise secured and without operational taps or valves;
- adequately maintained vehicles used in material handling; and
- final products, other than products that would be mobilized in storm water discharges (e.g., rock salt).
A No Exposure Certification must be provided for each facility qualifying for the no exposure exclusion. In addition, the exclusion from NPDES permitting is
available on a facility -wide basis only, not for individual outfalls. If any industrial activities or materials are or will be exposed to precipitation, the facility is
not eligible for the no exposure exclusion.
By signing and submitting this No Exposure Certification form, the entity in Section A is certifying that a condition of no exposure exists at its facility or site,
and is obligated to comply with the terms and conditions of 40 CFR I22.26(g).
ALL INFORMATION MUST BE PROVIDED ON THIS FORM.
Detailed instructions for completing this form and obtaining the no exposure exclusion are provided on pages 3 and 4.
A. Facility Operator Information
1. Name: NIP NIA IC I Of LYING I I I I I I I I I I I I I I I I I 11 1 2. Phone: T it r 24 14 1 (CI S-16 0
3. Mailing Address: a. Street..: 11ISI 01 / l 1QMI li G I1e Ir 1 ✓IFI 1 I I I I I I I I I I 11 I 1 1 1 1
L. City: L2IEI-61 Ill U 61 M I I I I I I I I I I I I I I I c. State: INIC I d. Zip Code: 12.19
B. Facility/Site Location Information
1. Facility Name: Inllar-LIA IC 101 / 11101C I I I I I II I I I I I I I I I I I I
2. a. Street Address: nn f)?0O1�I VtliUAlcipit,) k IA yfa:yri I I
L. City: Ir1 AFI Pi DI/L-I P I I I I I I I I I I I I I I I I c. County: IFIQ&l CId M Ii1F I
d. State: I N O e. Zip Code: Q,jV I?- Q- 4 1- 1 1 I I
3. Is the facility located on Indian Lands? Yes ❑ No
4. Is this a Federal facility? Yes ❑ No 15� p64 � %
5. a. Latitude: ICJ i I I I I I b. Longitude:
6. a. Was the facility or site previously covered under an NPDES storm water permit? Yes ® No ❑
b. If yes, enter NPDES permit number: 1,iiY1 2:06o?-"
7. SIC/Activity Codes: Primary: I,' A " Secondary (if applicable):
8. Total size of site associated with industrial activity: acres
9. a. Have you paved or roofed over a formerly exposed, pervious area in order to qualify for the no exposure exclusion? Yes ❑ No'
If. If yes, please indicate approximately how much area was paved or roofed over. Completing this question does not disqualify you for the no exposure
exclusion. However, your permitting authority may use this information in considering whether storm water discharges from your site are likely to have
an adverse impact on water quality, in which case you could be required to obtain permit coverage.
Less than one acre ❑ One to five acres ❑ More than five acres ❑
EPA Form 3510-11 (10-99) Page 1 of 4
NPDES NO EXPOSURE CERTIFICATION for Exclusion from Form Approved
FORM OMB OMB No. 2040-0211
3510-11 NPDES Storm Water Permitting
C. Exposure Checklist
Are any of the following materials or activities exposed to precipitation, now or in the foreseeable future?
(Please check either "Yes" or "No' in the appropriate box.) If you answer "Yes" to any of these questions
(1) through (11), you are not eligible for the no exposure exclusion.
Yes
No
1.
Using, storing or cleaning industrial machinery or equipment, and areas where residuals from using, storing
or cleaning industrial machinery or equipment remain and are exposed to storm water
2.
Materials or residuals on the ground or in storm water inlets from spillslleaks
3.
Materials or products from past industrial activity
4.
Material handling equipment (except adequately maintained vehicles)
5.
Materials or products during loading/unloading or transporting activities
6.
Materials or products stored outdoors (except final products intended for outside use [e.g., new cars] where
❑
P
exposure to storm water does not result in the discharge of pollutants)
7.
Materials contained in open, deteriorated or leaking storage drums, barrels, tanks, and similar containers
❑
8.
Materials or products handled/stored on roads or railways owned or maintained by the discharger
9.
Waste material (except waste in covered, non -leaking containers [e.g., dumpsters])
10.
Application or disposal of process wastewater (unless otherwise permitted)
El
0/
11.
Particulate matter or visible deposits of residuals from roof stacks and/or vents not otherwise regulated
0�
(i.e., under an air quality control permit) and evident in the storm water outflow
D. Certification Statement
I certify under penalty of law that I have read and understand the eligibility requirements for claiming a condition of "no exposure" and obtaining an
exclusion from NPDES storm water permitting.
I certify under penalty of law that there are no discharges of storm water contaminated by exposure to industrial activities or materials from the industrial
facility or site identified in this document (except as allowed under 40 CFR 122.26(g)(2)).
I understand that I am obligated to submit a no exposure certification form once every five years to the NPDES permitting authority and, if requested, to
the operator of the local municipal separate storm sewer system (MS4) into which the facility discharges (where applicable). I understand that I must
allow the NPDES permitting authority, or MS4 operator where the discharge is into the local MS4, to perform inspections to confirm the condition of no
exposure and to make such inspection reports publicly available upon request. I understand that I must obtain coverage under an NPDES permit prior
to any point source discharge of storm water from the facility.
Additionally, I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gathered and evaluated the information submitted. Based on my inquiry of the person or
persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is to the best of my
knowledge and belief true, accurate and complete. I am aware that there are significant penalties for submitting false information, including the possibility
of fine and imprisonment for knowing violations.
Print Name: �li l�'I£If.11l IU.( I IAILI%LZ.I I I I I I I I I I I I
Print Title:
Signature:
Date:
EPA Form 3510-11 (10-99) Page 2 of 4
O�jOF�vV]A7, 9
>b4
FACILITY INFORMATION
PERMIT COVERAGE
ON REQUEST FORM
National Pollutant Discharge Elimination System
Stormwater General Permit NCG0511000
NOMACO INCORPORATED
COC Number NCG05015S
Wake County
The following is the information currently in our database for your facility. Please review this information
carefully and make all corrections as necessary in the space provided to the right of the current
information.
Facility Name: NOMACO INCORPORATED
Location Address: 501 N,NIC DR
ZEBULON. NC 27597
Mailing Address*: 501 NMC DR
ZEBULON, NC27597
AL• 1 rewam
WRI-m. • � u1.I
Permit Contact MARK CAPUTO
Phone Number: 91926965(X) (919) 55L - 314-75— X22'Z
* This is the address to which the permit rescission notice will be mailed
Reason for rescission request: KM���f'' ]tr' i ..0'1C'aB3POl
REQUEST AND CERTIFICATION
I, as an authorized representative, hereby request rescission of coverage under NPDES Stormwater General
Permit NCG050000 for the subject facility. I am familiar with the information contained in this request and that
to the best of my knowledge and belief such information is true, complete and accurate.
Signature Date
'St) wr "f�f'Y1`IYl Jc`p' j Ulrecfrl—
Print or type name of person signing above Title
Please return this completed rescission request and any relevant documentation to:
General Permit Coverage Rescission
Attn: Valery Stephens
Stormwater and General Permits Unit For OlOco Usa ON
1617 Mail Service Center ReScssioll w DB
Raleigh, North Carolina 27699-1617 Request Date 11
NPDES
-�-�-�%
FORM
3510-11
Washington, DC
NO EXPOSURE CERTIFICATION for Exclusion from
NPDES Storm Water Permittingt;;;n1 nu,atlry
A. Facility Operator Information
1. Name: Nomaco -
2. Phone: 919-269-6500
3. Mailing Address: a. Street: 601 NMC Drive
b. City: Zebulon
c. State: NC
d. Zip Code: 27597
B. Facility/Site Location Information
1. Facility Name: Nomaco Zebulon
2. a. Street Address: 501 NMC Drive
b. City: Zebulon
c. County: Wake
d. State: NC
e. Zip Code: 27597
3. Is the facility located on Indian Lands? YES NO XX
4. Is this a Federal facility? Yes NO XX
5. a. Latitude: 35'49.9'59.16"
b. Longitude: 78'18.19'41.04"
6. a. Was the facility or site previously covered under an NPDES storm water permit?
Yes No XX
b. If yes, enter NPDES permit number:
7. SIC/Activity Codes: Primary: 3086 Secondary
Instructions for the NO EXPOSURE CERTIFICATION for
Exclusion from NPDES Storm Water Permitting
NPDES
FORM
3510-11
Form Approved
OMB No. 2040-0211
Section C. Exposure Checklist
Check "Yes" or "No" as appropriate to describe the exposure conditions at
your facility. If you answer "Yes" to ANY of the questions (1) through (11)
in this section, a potential for exposure exists at your site and you cannot
certify to a condition of no exposure. You must obtain (or already have)
coverage under an NPDES storm water permit. After obtaining permit
coverage, you can institute modifications to eliminate the potential for a
discharge of storm water exposed to industrial activity, and then certify to
a condition of no exposure.
Section D. Certification Statement
Federal statutes provide for severe penalties for submitting false information
on this application form. Federal regulations require this application to be
signed as follows:
For a corporation: by a responsible corporate officer, which means:
(i) president, secretary, treasurer, or vice-president of the corporation
in charge of a principal business function, or any other person
who performs similar policy or decision making functions for the
corporation, or
(n) the manager of one or more manufacturing, production, or
operating facilities, provided the manager is authorized to make
management decisions which govern the operation of the
regulated facility including having the explicit or implicit duty of
making major capital investment recommendations, and initiating
and directing other comprehensive measures to assure long
term environmental compliance with environmental laws and
regulations; the manager can ensure that the necessary systems
are established or actions taken to gather complete and accurate
information for permit application requirements; and where
authority to sign documents has been assigned or delegated to
the manager in accordance with corporate procedures;
For a partnership or sole proprietorship: by a general partner or the
proprietor; or .
For a municipal, State, Federal, or other public facility: by either a
principal executive or ranking elected official.
Paperwork Reduction Act Notice
Public reporting burden for this certification is estimated to average 1.0 hour
per certification, including time for reviewing instructions, searching existing
data sources, gathering and maintaining the data needed, and completing
and reviewing the collection of information. Burden means the total time,
effort, or financial resources expended by persons to generate, maintain,
retain, or disclose to provide information to or for a Federal agency. This
includes the time needed to review instructions, develop, acquire, install,
and utilize technology and systems for the purposes of collecting, validating,
and verifying information, processing and maintaining information, and
disclosing and providing information; adjust the existing ways to comply with
any previously applicable instructions and requirements; train personnel to
be able to respond to a collection of information; search data sources;
complete and review the collection of information; and transmit or otherwise
disclose the information. An agency may not conduct or sponsor, and a
person is not required to respond to, a collection of information unless it
displays a currently valid OMB control number. Send comments regarding
the burden estimate, any other aspect of the collection of information, or
suggestions for improving this form, including any suggestions which may
increase or reduce this burden to: Director, OPPE Regulatory Information
Division (2137), USEPA, 401 M Street, SW, Washington, D.C. 20460.
Include the OMB control number of this form on any correspondence. Do
not send the completed No Exposure Certification form to this address.
EPA Form 3510-11 (10-99) Page 4 of 4
y (if applicable):
8. Total size of site associated with industrial activity: _16.18 acres
9. a. Have you paved or roofed over a formerly exposed, pervious area in order to qualify for the no exposure exclusion?
Yes No XX
b. If yes, please indicate approximately how much area was paved or roofed over.
.Completing this question does not disqualify you for the no exposure
exclusion. However, your permitting authority may use this information in considering whether storm water discharges
from your site are likely to have
an adverse impact on water quality, in which case you could be required to obtain permit coverage.
Less than one acre One to five acres More than five acres
Submission of this No Exposure Certification constitutes notice that the entity identified in Section A does not require
permit authorization for its storm water
discharges associated with industrial activity in the State identified in Section B under EPA's Storm Water Multi -Sector
General Permit due to the existence
of a condition of no exposure.
A condition of no exposure exists at an industrial facility when all industrial materials and activities are protected by a
storm resistant shelter to prevent
exposure to rain, snow, snowmelt, and/or runoff. Industrial materials or activities include, but are not limited to, material
handling equipment or activities,
industrial machinery, raw materials, intermediate products, by-products, final products, or waste products. Material
handling activities include the storage,
loading and unloading, transportation, or conveyance of any raw material, intermediate product, final product or waste
product. A storm resistant shelter is
not required for the following industrial materials and activities:
—drums, barrels, tanks, and similar containers that are tightly sealed, provided those containers are not deteriorated and
do not leak. "Sealed"
means banded or otherwise secured and without operational taps or valves;
— adequately maintained vehicles used in material handling; and
— final products, other than products that would be mobilized in storm water discharges (e.g., rock salt).
A No Exposure Certification must be provided for each facility qualifying for the no exposure exclusion. In addition, the
exclusion from NPDES permitting is
available on a facility -wide basis only, not for individual outfalls. If any industrial activities or materials are or will be
exposed to precipitation, the facility is
not eligible for the no exposure exclusion.
By signing and submitting this No Exposure Certification form, the entity in Section A is certifying that a condition of no
exposure exists at its facility or site,
and is obligated to comply with the terms and conditions of 40 CFR 122.26(g).
ALL INFORMATION MUST BE PROVIDED ON THIS FORM.
Detailed instructions for completing this form and obtaining the no exposure exclusion are provided on pages 3
and 4.
20460
EPA Form 3510-11 (10-99) Pagel of 4
C. Exposure Checklist
Are any of the following materials or activities exposed to precipitation, now or in the foreseeable future?
(Please check either "Yes" or "No" in the appropriate box.) If you answer "Yes" to any of these questions
(1) through It 1), you are not eligible for the no exposure exclusion.
Yes No
1. Using, storing or cleaning industrial machinery or equipment, and areas where residuals from using, storing
or cleaning industrial machinery or equipment remain and are exposed to storm water Yes No XX
2. Materials or residuals on the ground or in storm water inlets from spills/leaks Yes No XX
3. Materials or products from past industrial activity Yes No XX
4. Material handling equipment (except adequately maintained vehicles) Yes No XX
5. Materials or products during loading/unloading or transporting activities Yes No XX
6. Materials or products stored outdoors (except final products intended for outside use [e.g., new cars] where
exposure to storm water does not result in the discharge of pollutants) Yes No XX
7. Materials contained in open, deteriorated or leaking storage drums, barrels, tanks, and similar containers
Yes No XX
6. Materials or products handled/stored on roads or railways owned or maintained by the discharger
Yes No XX
9. Waste material (except waste in covered, non -leaking containers [e.g., dumpsters]) Yes No XX
10. Application or disposal of process wastewater (unless otherwise permitted) Yes No XX
11. Particulate matter or visible deposits of residuals from roof stacks and/or vents not otherwise regulated
(i.e., under an air quality control permit) and evident in the storm water outflow Yes No XX
NO EXPOSURE CERTIFICATION for Exclusion from
NPDES Storm Water Permitting
D. Certification Statement
I certify under penalty of law that I have read and understand the eligibility requirements for claiming a condition of "no
exposure" and obtaining an
exclusion from NPDES storm water permitting.
I certify under penalty of law that there are no discharges of storm water contaminated by exposure to industrial activities
or materials from the industrial
facility or site identified in this document (except as allowed under 40 CFR 122.26(g)(2)).
I understand that I am obligated to submit a no exposure certification form once every five years to the NPDES permitting
authority and, if requested, to
the operator of the local municipal separate storm sewer system (MS4) into which the facility discharges (where
applicable). I understand that I must
allow the NPDES permitting authority, or MS4 operator where the discharge is into the local MS4, to perform inspections
to confirm the condition of no
exposure and to make such inspection reports publicly available upon request. I understand that I must obtain coverage
under an NPDES permit prior
to any point source discharge of storm water from the facility.
Additionally, I certify under penalty of law that this document and all attachments were prepared under my direction or
supervision in accordance with a
system designed to assure that qualified personnel properly gathered and evaluated the information submitted. Based on
my inquiry of the person or
persons who manage the system, or those persons directly responsible for gathering the information, the information .
submitted is to the best of my .
knowledge and belief true, accurate and complete. I am aware that there are significant penalties for submitting false
information, including the possibility
of fine and imprisonment for knowing violations.
Print Name: Julian Young
Print Title: Vice President of Operations
Signature:
Dale: 9/2/03
NPDES
FORM
3510-11
Form Approved
OMB No. 2040-0211
EPA Form 3510-11 (10-99) Page 2 of 4
Section B. Facility/Site Location Information
1. Enter the official or legal name of the facility or site.
2. Enter the complete street address (if no street address exists, provide
a geographic description [e.g., Intersection of Routes 9 and 55]), city,
county, stale, and zip code. Do not use a P.O. Box number.
3. Indicate whether the facility is located on Indian Lands.
4. Indicate whether the industrial facility is operated by a department or
agency of the Federal Government (see also Section 313 of the Clean
Water Act).
5. Enter the latitude and longitude of the approximate center of the facility
or site in degrees/minutes/seconds. Latitude and longitude can
be obtained from United States Geological Survey (USGS) quadrangle
or topographic maps, by calling 1-(888) ASK-USGS, or by accessing
the Census Bureau at: http://www.census.gov/cgi�bin/gazetteer.
Latitude and longitude for a facility in decimal form must be converted
to degrees (°), minutes I'), and seconds (") for proper entry on
the certification form. To convert decimal latitude or longitude to
degrees/minutes/seconds, follow the steps in the following example.
Example: Convert decimal latitude 45.1234567 to degrees (0), minutes
('), and seconds (").
a) The numbers to the left of the decimal point are the degrees: 45°.
b) To obtain minutes, multiply the first four numbers to the right of the
decimal point by 0.006: 1234 x 0.006 = 7.404.
c) The numbers to the left of the decimal point in the result obtained
in (b) are the minutes:
d) To obtain seconds, multiply the remaining three numbers to the
right of the decimal from the result obtained in (b) by 0.06:
404 x 0.06 = 24.24.
point are not used, the result is 24".
e) The conversion for 45.1234567 = 45° 7'
6. Indicate whether the facility was previously covered under an NPDES
storm water permit. If so, include the permit number.
7. Enter the 4-digit SIC code which identifies the facility's primary activity,
and second 4-digit SIC code identifying the facility's secondary activity,
if applicable. SIC codes can be obtained from the Standard Industrial
Classification Manual, 1987.
8. Enter the total size of the site associated with industrial activity in acres.
Acreage may be determined by dividing square footage by 43,560, as
demonstrated in the following example.
Example: Convert 54,450 ft2 to acres
Divide 54,450 112 by 43,560 square feet per acre:
54,450 ft2 143,560 ft2/acre = 1.25 acres.
9. Check "Yes" or "No" as appropriate to indicate whether you have paved
or roofed over a formerly exposed, pervious area (i.e., lawn, meadow,
dirt or gravel road/parking lot) in order to qualify for no exposure. If yes,
also indicate approximately how much area was paved or roofed over
and is now impervious area.
Instructions for the NO EXPOSURE CERTIFICATION for
Exclusion from NPDES Storm Water Permitting
NPDES
FORM
3510-11
Form Approved
OMB No. 2040-0211
Who May File a No Exposure Certification
Federal law at 40 CFR Part 122.26 prohibits point source discharges of
storm water associated with industrial activity to waters of the U.S. without
a National Pollutant Discharge Elimination System (NPDES) permit. However,
NPDES permit coverage is not required for discharges of storm water
associated with industrial activities identified at 40 CFR 122.26(b)(14)(i)-(
ix) and (xi) if the discharger can certify that a condition of "no exposure'
exists at the industrial facility or site.
Storm water discharges from construction activities identified in 40 CFR
122.26(b)(14)(x) and (b)(15) are not eligible for the no exposure exclusion.
Obtaining and Maintaining the No Exposure Exclusion
This form is used to certify that a condition of no exposure exists at the
industrial facility or site described herein: This certification is only applicable
in jurisdictions where EPA is the NPDES permitting authority and must be
re -submitted at least once every five years.
The industrial facility operator must maintain a condition of no exposure at
its facility or site in order for the no exposure exclusion to remain applicable.
If conditions change resulting in the exposure of materials and activities to
storm water, the facility operator must obtain coverage under an NPDES
storm water permit immediately.
Where to File the No Exposure Certification Form
No Exposure Forms
SW No Exposure Certification (4203M) SW No Exposure Certification
USEPA US EPA East Building, Rm. 7420
1200 Pennsylvania Avenue, NW
Washington, D.C. Washington, D.C.
Completing the Form
You must type or print, using uppercase letters, in appropriate areas only.
Enter only one character per space (i.e., between the marks). Abbreviate
if necessary to stay within the number of characters allowed for each item.
Use one space for breaks between words. One form must be completed
for each facility or site for which you are seeking to certify a condition of no
exposure. Additional guidance on completing this form can be accessed
at EPA's website: www.epa.gov/npdes/stormwater. Please make sure you
have addressed all applicable questions and have made a photocopy for
your records before sending the completed form to the above address.
Section A. Facility Operator Information
1. Provide the legal name of the person, firm, public organization, or any
other entity that operates the facility or site described in this certification.
The name of the operator may or may not be the same as the name of
the facility. The operator is the legal entity that controls the facility's
operation, rather than the plant or site manager.
2. Provide the telephone number of the facility operator.
3. Provide the mailing address of the operator (P.O. Box numbers may be
used). Include the city, state, and zip code. All correspondence will
be sent to this address.
7'.
Since the numbers to the right of the decimal
24".
sent overnight/express: Forms sent regular mail:
1201 Constitution Avenue, NW
20460 20004.
EPA Form 3510-11 (10-99) Page 3 of 4
(202) 564-9545
Please submit original document with signature in ink -DO NOT send copies.
Instructions for the NO EXPOSURE CERTIFICATION for
Exclusion from NPDES Storm Water Permitting
NPDES
FORM
3510-11
Form Approved
OMB No. 2040-0211
Section C. Exposure Checklist
Check "Yes" or "No" as appropriate to describe the exposure conditions at
your facility. If you answer "Yes" to ANY of the questions (1) through (11)
in this section, a potential for exposure exists at your site and you cannot
certify to a condition of no exposure. You must obtain (or already have)
coverage under an NPDES storm water permit. After obtaining permit
coverage, you can institute modifications to eliminate the potential for a
discharge of stone water exposed to industrial activity, and then certify to
a condition of no exposure.
Section D. Certification Statement
Federal statutes provide for severe penalties for submitting false information
on this application form. Federal regulations require this application to be
signed as follows:
For a corporation: by a responsible corporate officer, which means:
(i) president, secretary, treasurer, or vice-president of the corporation
in charge of a principal business function, or any other person
who performs similar policy or decision making functions for the
corporation, or
(n) the manager of one or more manufacturing, production, or
operating facilities, provided the manager is authorized to make
management decisions which govern the operation of the
regulated facility including having the explicit or implicit duty of
making major capital investment recommendations, and initiating
and directing other comprehensive measures to assure long
term environmental compliance with environmental laws and
regulations; the manager can ensure that the necessary systems
are established or actions taken to gather complete and accurate
information for permit application requirements; and where
authority to sign documents has been assigned or delegated to
the manager in accordance with corporate procedures;
For a partnership or sole proprietorship: by a general partner or the
proprietor; or
For a municipal, Stale, Federal, or other public facility: by either a
principal executive or ranking elected official.
Paperwork Reduction Act Notice
Public reporting burden for this certification is estimated to average 1.0 hour
per certification, including time for reviewing instructions, searching existing
data sources, gathering and maintaining the data needed, and completing
and reviewing the collection of information. Burden means the total time,
effort, or financial resources expended by persons to generate, maintain,
retain, or disclose to provide information to or for a Federal agency. This
includes the time needed to review instructions; develop, acquire, install,
and utilize technology and systems for the purposes of collecting, validating,
and verifying information, processing and maintaining information, and
disclosing and providing information; adjust the existing ways to comply with
any previously applicable instructions and requirements; train personnel to
be able to respond to a collection of information; search data sources;
complete and review the collection of information; and transmit or otherwise
disclose the information. An agency may not conduct or sponsor, and a
person is not required to respond to, a collection of information unless it
displays a currently valid OMB control number. Send comments regarding
the burden estimate, any other aspect of the collection of information, or
suggestions for improving this form, including any suggestions which may
increase or reduce this burden to: Director, OPPE Regulatory Information
Division (2137), USEPA, 401 M Street, SW, Washington, D.C. 20460.
Include the OMB control number of this form on any correspondence. Do
not send the completed No Exposure Certification form to this address.
EPA Form 3510-11 (10-99) Page 4 of 4